Understanding ACT at C4: A Deep Dive into Transformative Care

At C4, the Assertive Community Treatment (ACT) program serves as vital and essential support for those grappling with severe mental illness. We sat down with three of the dedicated members of this team, Program Manager, Laura Schoepfle, Team Lead, Oliver Oliver, a seasoned veteran with nearly 25 years of experience, and Case Manager, Kelsey Kamin, a recent hire, to delve into their experiences and insights about working in this transformative program.

Addressing Complex Needs

In the city of Chicago, the challenge of addressing Severe Mental Illness (SMI) is magnified by insufficient infrastructure and investment. A 2016 survey of local behavioral health providers revealed that 17% of respondents recognized a demand for Assertive Community Treatment (ACT) services but felt unable to provide them adequately or at all. Compounding this issue, among the sixteen facilities that did offer ACT, six had waitlists stretching a year or longer.

The lack of comprehensive, accessible treatment contributes to the overutilization of emergency rooms and hospitals. Based on recent data from the Chicago Department of Public Health (CDPH), in 2023, the city reported a total of 220 suicide deaths among its residents. Behavioral health-related hospitalizations remain a significant concern, with mood and depressive disorders being prevalent. In response to these challenges, C4’s ACT program is designed to address these intersecting issues, offering a holistic approach to support and care that aims to alleviate the burdens on emergency services and improve the overall well-being of our clients.

Individuals with SMI often face compound challenges in securing stable housing, obtaining employment, and accessing medical care. C4’s ACT program is designed to tackle these intersecting issues head-on. Our dedicated staff meet clients at both our Broadway facility and within the community, offering transportation for appointments and errands as needed. They provide guidance through medical and behavioral health treatments, assist in securing employment, and ensure stable living environments while connecting clients with additional resources.

The situation is particularly dire for youth in care, as highlighted by a recent report from the Illinois Department of Children & Family Services (DCFS), which shows over 500 youth residing in these underserved communities. As these young individuals age out of the DCFS system, they often lose their safety nets and face a heightened risk of substance abuse, mental illness, and homelessness.

Balancing Support and Independence

Laura Schoepfle, the ACT Program Manager at C4, plays a pivotal role in the success of the program. Her leadership and extensive experience are crucial in managing the program’s complexities and dynamics, ensuring it effectively supports clients’ needs. Schoepfle emphasizes the multidimensional nature of the ACT team, which includes not only caseworkers but also specialists, who lead substance abuse support groups. This collaborative environment provides clients with a range of services beyond their one-on-one interactions. The on-site drop-in center, which houses a pharmacy and banking services, often becomes a comfortable space for clients, making it difficult to motivate them to step outside and explore the community, which Schoenfeld says is necessary. Balancing community engagement with the program’s supportive environment is an ongoing challenge.

The emotional demands of working in mental health care are significant, and Schoepfle recognizes the importance of self-care for her team. She has implemented initiatives like “Mindfulness Monday,” where she shares strategies related to self-care, helping staff maintain their well-being amidst the high-intensity nature of their work. Schoepfle believes that self-care goes beyond rest; it involves staying sharp and motivated to prevent burnout. Her commitment to fostering a supportive work environment reflects her belief in the importance of emotional resilience for both clients and staff.

Schoepfle addresses the challenge of balancing client autonomy with effective treatment. Many clients, accustomed to rigid hospital environments, may initially perceive ACT recommendations as directives rather than collaborative decisions. To bridge this gap, the program includes peer support specialists who facilitate a more collaborative relationship between clients and their caseworkers. This approach helps clients feel more in control of their treatment and reinforces their autonomy, which is crucial for fostering long-term success.

For those considering a career in ACT or are new on her team, Schoepfle offers straightforward advice: dive in and embrace the experience. She encourages new team members to be open and creative, as the role offers numerous opportunities for innovative approaches to client care. Schoepfle values the diverse perspectives and approaches that team members bring, whether they are new to the field or seasoned professionals.

Building Trust and Expertise

Since joining C4 a few months ago, Kelsey Kamin has had ample opportunity to put her collegiate studies into practice with the ACT team. Like most new clinicians, Kamin has found that her academic training didn’t fully equip her for the real-world demands of crisis management and self-care. “While my classes offered a solid foundation, the real-world experience has been invaluable. There’s no substitute for the hands-on learning that comes from working directly with clients and facing real challenges” explains Kamin.

One of the challenges Kamin has experienced has to do with trust. Kamin who is also pursuing a Master’s degree in Social Work says, “Many clients have gone through several case managers and they are tired of starting over with someone new.” While Kamin found some of her clients to be shy to open up now says she is having great conversations with clients who have expressed that she is trustworthy. She believes the supportive environment at C4 has been pivotal in her growth. She credits her colleagues for their steadfast support in navigating challenging situations, which has been instrumental in her professional development. Through consistent and authentic interactions, Kamin has deepened her client relationships, demonstrating a profound sensitivity to their burnout and ongoing needs.

Kamin’s caseload consists of several clients that she is seeing almost on a daily basis. She supports them with completing basic daily tasks like hygiene, checking email and making appointments. She also counsels them in how to manage crisis as they arise. “So much of their life is overwhelming for them. I want to be able to help them manage it all,” she says. But through the mentorship of her peers Kamin is learning to manage her own stress as well. “I take breaks between clients. I will go outside. Drink water. I am intentional about practicing self-care.”

Long-Term Commitment

Reflecting on his early days, Travis Oliver’ journey at C4 began almost 25 years ago, a tenure that speaks volumes about his dedication and the deep connection he has with the organization and its mission. Oliver recalls his transition from California to Chicago in the late ’90s, driven by his wife’s acceptance into Northwestern’s JD/MBA program. Leaving behind a career with the Department of Justice and a background working with juveniles in group homes, Oliver found his calling at C4.

Initially part of the Psychosocial Rehabilitation (PSR) program, Oliver transitioned to the ACT team in 2017. The shift was significant, marking a deeper engagement with individuals facing severe mental health challenges. “ACT is like the last step before hospitalization or long-term care,” Oliver explains. “We deal with individuals struggling with severe mental illness and substance abuse, those at risk of losing their housing or facing incarceration. It’s a very challenging population.”

Despite the challenges, Oliver believes in the unique nature of ACT. “It takes a special kind of person to work here. You need to leave your ego, biases, and prejudices at home. It’s all about seeing the human being and showing love in spite of everything.” His philosophy revolves around consistency and genuine care, building trust over time. “Clients need to know that you are there for them, no matter what. It’s about being present in their darkest moments and not giving up on them.”

Oliver shares memorable stories of clients like “Mr. Ray”, who had multiple suicide attempts and hospitalizations before joining ACT. Through genuine support and highlighting small victories, Ray has seen significant improvement. Another client, who we will call “Mr. Sterns”, known for his aggressive behavior and multiple program failures, has found stability at C4 for over two and a half years. “It’s about being there, not judging, and showing up every day,” Oliver emphasizes.

The Essence of ACT

At C4, the ACT program is more than just a treatment model; it is a profound commitment to making a significant difference in the lives of those we serve. Through compassionate care and unwavering support, our team members like Kamin and Oliver exemplify the powerful potential of this approach.

Supported by the leadership of the Director of Specialized Services, Alicia Kane, and Associate Director of Specialized Services, Herbert Cobbs, this multidisciplinary approach ensures clients receive continuous, personalized care that addresses all facets of their lives. Furthermore, they foster an environment where clinicians can thrive and continue to make substantial, positive changes in the lives of their clients. Emphasis on community-based support facilitates stability and the pursuit of personal goals. This team embodies the program’s values of teamwork, empathy, and resilience, demonstrating the transformative impact of dedicated professionals in creating meaningful, positive changes in clients’ lives.

To learn more about C4’s ACT Program or to be connected for services please visit our website www.c4chicago.org.